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HomeMy WebLinkAboutExhibit D- Disclosure of Lobbying ActivitiesEXHIBIT "D" DISCLOSURE OF LOBBYING ACTIVITIES DISCLOSURE OF LOBBYING ACTIVITIES Complete this form to disclose lobbying activities pursuant to 31 U.S.C. 1352 1. Type of Federal Action: 2. Status of Federal Action: 3. Report Type: 64-i' 015'. Contract Ea e' Bid /offer /application initial filing b. Grant b. Initial award b. Material change c. Cooperative agreement c. Post -award For Material Change Only: d. Loan Year Quarter e. Loan guarantee Date of last report f. Loan insurance 4. Nanj"nd Address of Reporting Entity: 5. If Reporting Entity in No. 4 is Subawardee. Enter Name Prime ❑ Subawardee and Address of Prime: UN 1 JF tR'; V 600-P, Tier if known ongressibnal District, if known: Congressional District, if known: 6. Federal Department/Agency: 7. Federal Program Name /Description: CFDA Number, if applicable 8. Federal Action Number, if known: 9. Award Amount, if known: 10. Name and Address of Lobbying Entity b. Individuals Performing Services (including address if (If individual, last name, first name, MI): different from No. 10a) (Last name, first name, MI): 11. Information requested through this form is authorized by Title Signature: 31 U.S.C. Section 1352. This disclosure of lobbying activities is a Print Name: = material representation of fact upon which reliance was placed by the tier above when this transaction was made or entered into. This disclosure is required pursuant to 31 U.S.C. 1352. This Title: -- _4 E i C10 information will be reported to the Congress semi - annually and will fails to file the be available for public inspection. Any person who Telephone No.: Date: required disclosure shall be subject to a civil penalty of not less than $10,000 and not more than $100,000 for each such failure. Federal Use Only: Authorized for Local Reproduction Standard Form — LLL Rev. 7 -97 Standard Form LLL Rev. Uti -U4 -9U FARequest for Proposal tech center mod.doc VENDORS PROPOSAL AND COMPENSATION STATEMENTS VENDORS PROPOSAL AND COMPENSATION STATEMENTS A. We, UniFirst Corporation agree that this RFP shall be incorporated in its entirety as a part of our proposal. - ( �, manager). -ter- � ,, �_____ sales mana er . B. This RFP and UniFirst Corporation proposal will jointly become part of the agreement for services for the Employee Uniform Program when said agreement is fully executed by UniFirst Corporation and the Mayor or City Manager of Lake Elsinore. (sales manager). C. Unifirst Corporation Services to be provided, and fees therefor, will be in accordance with the City's RFP except as otherwise specified in UniFirst Corporation proposal under the heading "ADDITIONS OR EXCEPTIONS TO THE CITY'S REQUEST FOR PROPOSAL." - (sales manager). D. A single and separate section with the heading "ADDITIONS OR EXCEPTIONS TO THE CITY'S REQUEST FOR PROPOSAL" containing a complete and detailed description of all of the exceptions to the provisions and conditions of this Request for Proposal upon which UniFirst Corporation Proposal is contingent and which shall take precedent over this RFP �- (sales manager). E. A listing of recent similar services completed or currently under contract including the names, titles, addresses and telephone numbers of the appropriate persons whom the City could contact. (sales manager). F. UniFirst Corporation agrees that we will not discriminate against any employee or applicant for employment because of race, color, religion, sex, or national origin. sa es manager). G. UniFirst Corporation agrees that all federal laws and regulations shall be adhered to notwithstanding any state or local laws and regulations. In a case of conflict between federal, state or local laws or regulations the strictest shall be adhered to. (sales manager). H. UniFirst Corporation shall allow all authorized federal, state, county, and City officials access to place of work, books, documents, papers, fiscal, payroll, materials, and other relevant contract records pertinent to this service. All relevant records shall be retained for at least three years. (sales manager). I. UniFirst Corporation shall comply with the Davis -Bacon Fair Labor Standards Act (40 USC 276 -a through a -7), and the implementation regulations issued pursuant thereto (29 CFR Section 1,5), any amendments thereof and the California Labor Code. Pursuant to the said regulations, entitled "Federal Labor Standards Provisions," Federal Prevailing Wage Decision" and State of California prevailing wage rates, respectively. - -. - (sales manager). J. UniFirst Corporation shall comply with the Copeland Anti - Kickback Act (18 USC 874) and the Implantation Regulation (29 CFR 3) issued pursuant thereto, and any amendments thereof. - (sales manager). K. UniFirst Corporation offers and agrees to assign to the City all rights, title, and interest in and to all causes of action it may have under section 4 of the Clayton Act (15 USC Sec. 15) or under the Cartwright Act (Chapter 2 {commencing with section 167001 of Part 2 of Division 7 of the Business and Professions Code), arising from purchase of goods, services, or materials pursuant to the public works or the subcontract. This assignment shall be made and become effective at the time the city tenders final payment to UniFirst Corporation, without further acknowledgement by the parties. (sales manager). L. Complete Disclosure of Lobbying Activities. (sales manager).